152,399 results on '"Myocardial infarction"'
Search Results
2. MYOCARDIAL infarction; an epidemiologic and prognostic study of patients from five departments of internal medicine in Oslo 1935-1949.
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- Humans, Prognosis, Cardiovascular Diseases, Internal Medicine, Myocardial Infarction
- Published
- 1956
3. [SOME CLINICAL PROBLEMS OF THROMBOELASTOGRAPHIC BLOOD COAGULATION TESTS IN INTERNAL DISEASES].
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ZHAVORONKOVA EK
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- Humans, Blood Coagulation Tests, Internal Medicine, Kidney Diseases, Myocardial Infarction, Thrombelastography
- Published
- 1964
4. [Emergencies in internal medicine. XIX. Myocardial infarct].
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HALHUBER MJ and KIRCHMAIR H
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- Humans, Emergencies, Internal Medicine, Myocardial Infarction
- Published
- 1957
5. Empagliflozin Post-Acute Myocardial Infarction.
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MYOCARDIAL infarction complications , *HEART failure risk factors , *EMPAGLIFLOZIN , *MYOCARDIAL infarction , *RISK assessment , *PLACEBOS , *HOSPITAL care , *CAUSES of death , *HEART failure , *TREATMENT effectiveness , *SODIUM-glucose cotransporter 2 inhibitors , *INTERNAL medicine , *STROKE volume (Cardiac output) - Abstract
The article focuses on the impact of empagliflozin on heart failure hospitalizations following acute myocardial infarction. Topics include the results of the EMPACT-MI trial; which found that empagliflozin reduced heart failure hospitalizations but did not impact mortality; the characteristics of patients in the trial; and the considerations for prescribing this drug based on its effectiveness and cost.
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- 2024
6. 'SKS is not dead' - A Case Report Of Dual Stenting Technique in the Management of a Complex Coronary Bifurcation Lesion During ST Elevation Myocardial Infarction
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Sever Risca, Alexandru Ispas, Alexandra Gherghina, Irina Pintilie, and Florin Ortan
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bifurcation lesion ,dual stenting technique ,myocardial infarction ,stemi ,leziune de bifurcație ,tehnică dual stenting ,infarct miocardic ,Internal medicine ,RC31-1245 - Abstract
Cardiac interventions in the setting of a ST-elevation myocardial infarction (STEMI) often require complex decision-making, especially when confronted with coronary bifurcation lesions. Although provisional stenting is the first choice regarding revascularization, bailout or upfront two stents may be required.
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- 2024
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7. Drug safety: focus on long-term therapy with proton pump inhibitors. Possible cardiovascular risk and rare side effects
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Dmitry I. Trukhan
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proton pump inhibitors ,drug safety ,side effects ,cardiovascular risk ,adverse cardiovascular events ,myocardial infarction ,stroke ,dementia ,erectile dysfunction ,diabetes mellitus ,bronchial asthma ,chronic obstructive pulmonary disease ,Internal medicine ,RC31-1245 - Abstract
Proton pump inhibitors are the most effective drugs for the treatment of acid-related diseases. In recent decades, the use of PPIs has increased exponentially. For a long time, PPIs were considered completely safe drugs for both short-term and long-term use. However, modern clinical guidelines note that when prescribing PPIs in large doses for a long period, the possibility of side effects should be taken into account. There are no reviews in the domestic literature on the safety of PPIs during long-term use. In this regard, a search was conducted in the PubMed and Scopus information databases for publications on the safety of PPI use, including sources up to November 15, 2023, which showed that long-term use of PPIs is associated with the possible development of numerous side effects. The first publications examined the likely side effects of long-term use of PPIs: the development of infections, increased risk of fractures and kidney pathology, and possible side effects: the risk of cancer and electrolyte disturbances. This review examines the possible cardiovascular risk of long-term PPI use and a number of rare side effects, many of which have been described in recent years. The key to mitigating side effects is judicious use of PPIs at the lowest effective dose and as quickly as possible. If there are clear indications for long-term PPI use, monitoring should be carried out to identify side effects.
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- 2024
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8. Myocarditis Presenting as Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) in a Young Man: A Case Report
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Giovanni Reynaldo, Rachmat Hamonangan, and Princella Monica
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minoca ,myocarditis ,myocardial infarction ,angiography ,chest pain ,electrocardiogram ,Internal medicine ,RC31-1245 - Abstract
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a unique disorder that manifests as an acute myocardial infarction clinically without overt coronary arteries obstruction on angiography. Herein, we report a 17-year-old male presented with a chest pain occurring 3 hours before admission and fever lasting for 2 days. Electrocardiogram examination showed ST elevation in lead II, III, aVF and V3-V6. Laboratory tests results showed a normal leukocyte level of 9850/µL, an elevated troponin of 3.55 ng/mL and an elevated quantitative CRP of 46 mg/L. Coronary angiography performed, indicating 20-30% stenosis of the left anterior descending artery, left circumflex artery and right coronary artery, whereas in typical acute myocardial injury, angiography shows >50% coronary stenosis. Additional cardiac MRI examination showed a fulfillment of Lake Louis Criteria for myocarditis, with further findings of acute myocardial edema in the lateral wall of left ventricle, with left ventricle ejection fraction of 59.73%. As researchers are still working on the definition of MINOCA, present knowledge of the causes, pathophysiology, clinical features, or specific phenotypes of MINOCA is also limited. A stepwise diagnostic approach is needed to diagnose MINOCA, with subsequent differential diagnosis exclusion.
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- 2023
9. The effects of socioeconomic status on major adverse cardiovascular events: a nationwide population-based cohort study
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Eun Hui Bae, Sang Yup Lim, Eun Mi Yang, Tae Ryom Oh, Hong Sang Choi, Chang Seong Kim, Seong Kwon Ma, Bongseong Kim, Kyung-Do Han, and Soo Wan Kim
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death ,myocardial infarction ,renal dysfunction ,stroke ,Internal medicine ,RC31-1245 ,Specialties of internal medicine ,RC581-951 - Abstract
Background Although multiple factors influence the risk of major adverse cardiovascular events (MACE), the effects of socioeconomic status on MACE in the presence and absence of renal dysfunction (RD) have not been comprehensively explored in Korea. Methods We examined the effects of socioeconomic status on MACE in individuals with and without RD. The data of 44,473 Koreans from 2008 to 2017 were obtained from the Health Care Big Data Platform of the Ministry of Health and Welfare in Korea. Their socioeconomic status was assessed using a socioeconomic score (SES) based on marital status, education, household income, and occupation. The incidence of myocardial infarction (MI), stroke, and death was compared according to SES level (0–4). Multiple linear regression analysis was used to evaluate the hazard ratios and 95% confidence intervals for outcomes based on participant SES. Results MI risk was only affected by education level. The participants’ income, education, and SES affected their stroke risk, whereas death was associated with all four socioeconomic factors. The incidence of stroke and death increased as SES worsened (from 0 to 4). SES was positively related to risk of stroke and death in participants without RD. SES did not affect MI, stroke, or death in participants with RD. Conclusion A low socioeconomic status is associated with risk of stroke and death, especially in individuals without RD.
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- 2023
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10. Association between increase level of high-sensitive CRP (hs CRP) and non-arrhythmic ECG changes and echocardiographic abnormalities in patients with acute coronary syndrome
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Roholla Hemmati, Yousof mohsenzadeh, and Reza madday
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crp ,acute coronary syndrome ,ecg ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Background: Abnormality in the cardiovascular system such as left ventricular dysfunction caused increased serum CRP and change in electrocardiography pattern. The present study aimed to understand the association between increased levels of highly sensitive CRP (hs-CRP) and non-arrhythmic ECG changes and electrocardiographic abnormalities in patients with the acute coronary syndrome. Methods: This study was done on 120 patients diagnosed with acute coronary syndrome and hospitalized at CCU. The patients were classified into two groups, one group with an increased level of hs-CRP and another with a normal hs-CRP level. Results: The patients with an increased level of hs-CRP showed a significantly higher level of cardiac enzymes also ST-segment elevation myocardial infarction (STEMI) was seen in the group with an increased level of hs-CRP than those with normal serum hs-CRP level, but another diagnosis including unstable angina, non-STEMI, heart failure, and emergency hypertension was similarly observed in both groups. Two groups were assessed in terms of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVeDD) the prevalence of valvular heart disease, and wall motion abnormality, also showed that groups with increased hs-CRP level, ST-segment elevation leads more significant differences than a normal group (P=0.001). Conclusion: Patients with an increased level of hs-CRP can be diagnosed as STEMI but not valuable to suppose as echocardiographic abnormalities such as left ventricular dysfunction or hypertrophy.
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- 2023
11. Stem Cell Therapy in Myocardial Infarction: Still Therapeutic Hope?
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Oancea Alexandru Florinel, Chipăilă Elena Diana, Iov Elena Diana, Morariu Paula, Tănase Daniela Maria, and Floria Mariana
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myocardial infarction ,stem cell ,therapy ,transplant ,regenerative medicine ,infarct miocardic ,celule stem ,medicină regenerativă ,Internal medicine ,RC31-1245 - Abstract
Myocardial infarction is still a therapeutic rollercoaster challenge because, despite revolutionary treatments in its management, heart failure is still a consequence. Stem cell therapy might be a turning point in treating myocardial infarction patients for regaining what is lost—that is, myocardial tissue. This paper reviews the latest evidence for using stem cell therapy in the treatment of myocardial infarction, the results of this possible therapy regarding regaining cardiomyocytes, and the extent to which therapy with stem cells can be used in the future for the management of acute coronary syndromes.
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- 2022
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12. ST Segment Elevation
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Lucaci Laurențiu
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st segment ,elevation ,myocardial infarction ,non-ischaemic causes ,supradenivelare ,infarct miocardic ,cauze non-ischemice ,Internal medicine ,RC31-1245 - Abstract
As the earliest indirect sign of an acute coronary occlusion arriving against non-operative collateral heart vessels, the unabating ST segment elevation accounts for the acute coronary syndrome asking for mandatory and immediate reperfusion therapy. The geography of the ST segment elevations usually enables one to identify the culprit artery and to guess its likely occlusion site, as pivotal pieces of the necessary vital risk forecasting, along with somehow expected occurring arrhythmias. Aside from the classical ST segment elevation myocardial infarction (STEMI) pattern, a handful of distinctive non-ST elevation appearances of the acute coronary occlusion also need imperative reperfusion therapy, thus qualifying themselves as STEMI equivalents. The early forthcoming of ST elevation during an acute transmural ischaemic episode, as well as the wide availability of the electrocardiogram, make it an invaluable diagnostic tool. Yet many confounding factors are able to limit the diagnostic sensibility of ST elevation (as for example its customary absence in the conventional leads in some cases of circumflex artery occlusion, or the casual mutual cancellation of the transmural ST vectors from opposite ventricular walls), the accuracy of the electrocardiographic localisation of the occlusion site (due to coronary anatomic variants, concomitant new or old coronary lesions elsewhere, previous coronary artery bypass grafts), as well as its specificity for transmural ischaemia (by virtue of a well-known manifold of non-ischaemic causes). While the STEMI patient must be offered undelayed reperfusion therapy, the non-ischaemic ST elevation one should be kept away from the haemorrhagic risk of a useless invasive procedure.
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- 2022
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13. An observational study to evaluate the relation between infarction type, site, and the degree of conductive system damage
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K Sangeetha, S Myilsamy, Praveen Vijayakumar, and Panneerselvam Periaswamy
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conduction system of heart ,coronary artery ,ischemic heart disease ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Background: Obesity, insulin resistance, and type 2 diabetes mellitus are all on the rise, and they are all significant risk factors for ischemic heart disease (IHD). The prevalence of risk factors for IHD is quickly growing in developing countries as a result of urbanization. Large rises in IHD are observed around the world, and IHD has overtaken cancer as the leading cause of death after 2020. Materials and Methods: This is a 6-month prospective observational research undertaken at a tertiary care hospital where the myocardial infarction (MI) patients admitted to the intensive coronary care unit were included in the study. Results: Atrioventricular (AV) block was absent in 178 of 200 patients with acute MI. AV block was found in 22 of the remaining cases. The following is the frequency of each form of AV block: 12 patients had type 1 AV block. In five of the cases, type 1, 3 transition was found. Type 2 AV block was found in two cases. In one case, there was a 2, 3 transition. Conclusion: Preventing conduction system block may require the effective management of hypertension and maintaining appropriate blood glucose levels.
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- 2023
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14. Low high density lipoprotein cholesterol levels and acute coronary syndrome in young patients admitted at a tertiary care facility
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Arpita Chakraborty, CH Sai kumar, Mukhyaprana Prabhu, Weena Stanley, and Ranjan Shetty
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acute coronary syndrome ,coronary artery disease ,hdl cholesterol ,myocardial infarction ,gensini score ,Internal medicine ,RC31-1245 - Abstract
Background: Coronary artery disease (CAD) is a cardiovascular disease which is related to mortality and morbidity among the Indians predominantly in the older age group. But, recently CAD has been found more often in young population. Hence, our study aims to observe the outcomes based on various categories of high density lipoprotein (HDL) cholesterol levels estimated during admission at the hospital and correlate the levels of HDL cholesterol with severity of CAD as measured by Gensini score. Methods: A cross-sectional study was conducted in 151 young patients (18-45 years) who were admitted at the hospital with newly diagnosed acute coronary syndrome (ACS). Tests such as electrocardiogram, cardiac enzyme assay, hematologic and biochemical tests including fasting lipid profile levels were taken into account. Results: There was an inverse relation observed between the number of vessels involvedand HDL cholesterol levels. Those with lower levels of HDL cholesterol were more vulnerable to multi-vessel CAD. However, no association was observed between HDL cholesterol and severity of CAD as measured by Gensini score. Conclusion: In young patients with acute coronary syndrome and diminished HDL cholesterol levels had a greater number of vessels involved when compared with elevated HDL cholesterol levels group. However, low HDL cholesterol levels had no association with severity of CAD as measured by Gensini score. No statistically significant association was noticed between levels of HDL cholesterol and in hospital mortality /morbidity.
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- 2022
15. Sometimes Late Is Better Than Never: Implantation of a Cardioverter Defibrillator Years after an Acute Myocardial Infarction —Case Report
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Zamfirescu Maria, Ștefan Miruna Florina, Vintila Vlad Damian, and Magda Stefania Lucia
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myocardial infarction ,ventricular tachycardia ,secondary prevention ,covid-19 ,pulmonary embolism ,myocardial inflammation ,infarct miocardic ,tahicardie ventriculara ,preventie secundara ,embolie pulmonara ,inflamatie miocardica ,Internal medicine ,RC31-1245 - Abstract
Sustained ventricular arrhythmias that occur early post-myocardial infarction (MI) are generally considered epiphenomena of the MI and are not consistently associated with long-term prognosis. The lack of association with long-term prognosis is more clearly established for early ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PVT). Sustained monomorphic ventricular tachycardia (SMVT), even when it occurs early, however, may reflect a permanent arrhythmic substrate1. Patients with COVID-19 have a high risk of thromboembolic events, and the virus has also been shown to have extensive effects on the cardiovascular system2,3,4. A 62-year-old woman, recently hospitalized for COVID-19 pneumonia, was brought to the emergency department with pulseless SMVT having been successfully resuscitated in the prehospital setting. The patient has a history of an old MI treated with thrombolysis and percutaneous coronary intervention (PCI) that was complicated with early SMVT, but with preserved left ventricular function and without heart failure. The patient underwent implantation of a cardioverter defibrillator (ICD). During the hospitalization, she developed dyspnea and was diagnosed with minor pulmonary embolism. It may be appropriate to consider early SMVT as a predictor of adverse late outcomes that would necessitate rigorous follow-up and maybe an early invasive primary prevention strategy. This case also reflects the possibility of long-term cardiac involvement and increased thromboembolic risk in patients recovering from COVID-19.
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- 2022
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16. Clinical implications and current perspectives of statin-induced rhabdomyolysis syndrome – case presentation
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Ciobanu Elena Cosmina, Ungurenasu Andreea Simona, Haba Mihai Ștefan Cristian, Petris Antoniu Octavian, and Mitu Ovidiu
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statins ,hypercholesterolemia ,myocardial infarction ,statin-induced myopathy ,rhabdomyolysis ,pcsk9 inhibitors ,statine ,hipercolesterolemie ,infarct miocardic ,miopatie indusă de statine ,rabdomioliză ,inhibitori de pcsk9 ,Internal medicine ,RC31-1245 - Abstract
Though rare, statins can produce serious adverse effects with clinical implications that urge prompt intervention. However, in high-risk patients that require intense hypolipemiant treatment, such situations can be challenging and require complimentary therapies. We report the case of a 82-year-old hypertensive female patient admitted for diffuse myalgia, mainly in the lower limbs, fatigue and shortness of breath. The patient is known with a recent myocardial infarction (MI) treated by primary stent implantation. The electrocardiogram and transthoracic echocardiography confirmed the recent MI, with non-dilated left ventricle mildly reduced ejection fraction. Initial laboratory studies revealed elevated NT-proBNP, moderate renal impairment and increased serum levels of creatine kinase (CK), CK-MB fraction and transaminases. After stopping statin and receiving supportive treatment, the patient's paraclinical test results and symptoms improved: CK levels and transaminase dropped significantly and both myalgia and general fatigue resolved mostly within 4 days. PCSK9 inhibitor has been introduced with favourable results at follow-ups. Even though statins are effective and safe, they may still generate potential dangerous adverse effects in rare cases. Statin dose adjustment or replacement and adding other lipid lowering therapies represent current therapeutical options, especially in high-risk populations.
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- 2022
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17. Prevalence of Periodontal Disease among Patients at the Outpatient Clinic of Internal Medicine in an Academic Hospital in The Netherlands: A Cross-Sectional Pilot Study.
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Leung, Thomas J. T., Nijland, Nina, Gerdes, Victor E. A., and Loos, Bruno G.
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PERIODONTAL disease , *DISEASE prevalence , *MEDICAL subject headings , *MYOCARDIAL infarction , *INTERNAL medicine , *PILOT projects - Abstract
There is a worldwide increase in individuals suffering ≥2 chronic diseases (multimorbidity), and the cause of combinations of conditions remains largely unclear. This pilot study analysed the prevalence of periodontal disease (PD) among (multi)-morbid patients at the outpatient clinic of internal medicine. PD is an inflammatory disease of the tooth supporting tissues and has a negative impact on the overall health. Data were obtained from 345 patients, on demographics, systemic conditions and presence of PD. The possible differences in the distribution of PD status among patients with/without multimorbidity and Medical Subject Headings (MeSH) disease chapters were explored. In total, 180 (52.2%) patients suffered from multimorbidity. The prevalence of severe PD was 16.2%, while the prevalence of mild and severe PD combined (Total PD) was 53.6%. Patients with disease chapter cardiovascular diseases (CVD) had a significantly higher prevalence of severe PD (odds ratio (OR) 2.33; 95% confidence interval (CI) 1.25, 4.33) and Total PD (OR 1.61; 95% CI 1.04, 2.50) than patients without CVD. After subsequent analyses, myocardial infarction was significantly associated with severe PD (OR: 4.68 (95% CI; 1.27 to 17.25)). Those suffering from multimorbidity showed to have a non-significant increased risk for severe (OR 1.27; 95% CI 0.69, 2.34) or Total PD (OR 1.23; 95% CI 0.81, 1.88). In conclusion, PD is highly prevalent in multimorbidity patients. Furthermore, PD was significantly prevalent in patients with CVD. However, larger epidemiological studies are necessary to confirm that the prevalence of PD is significantly increased among multimorbid patients. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Association between admission blood glucose and prognosis in non-diabetic patients with first-ever acute myocardial infarction
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Eskandari Ramin, Matini Parisa, Emami Sepideh, and Rezaei Yousef
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myocardial infarction ,acute coronary syndrome ,hyperglycemia ,blood glucose ,mortality ,Internal medicine ,RC31-1245 - Abstract
Background: Admission hyperglycemia has been associated with major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome.
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- 2022
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19. A complicated case of myocardial infarction with nonobstructive coronary arteries with an underlying pheochromocytoma: a case report
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Sodam Jung and In Sook Kang
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Pheochromocytoma ,Myocardial infarction ,Cerebral hemorrhage ,Catecholamine ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Abstract Background The signs and symptoms of pheochromocytoma can imitate those of many other diseases, which may result in confusion. Therefore, diagnosing and treating secondary hypertension due to pheochromocytoma in deteriorating patients becomes challenging. Case presentation A 63-year-old female patient presented to the emergency room with severe and progressive nausea. The initial diagnosis was an acute myocardial infarction based on ST-segment depression on electrocardiogram and elevated cardiac markers. Elective coronary angiography revealed nonobstructive coronary arteries. However, she suffered from a complicated clinical course for several weeks during her life-or-death crisis. She was subsequently diagnosed with a cerebral hemorrhage and a pheochromocytoma. It is unclear whether her initial presentation was due to the neurogenic stunned myocardium caused by a cerebral hemorrhage or type 2 myocardial infarction caused by a pheochromocytoma, or both. However, this case showed the significance of accurately diagnosing and treating underlying causes in patients presenting with myocardial infarction with nonobstructive coronary arteries. Early diagnosis and treatment of the pheochromocytoma may have prevented the complications experienced by the patient. Conclusions A catecholamine surge and blood pressure fluctuation caused severe complications. When a patient presents with an unusual clinical presentation, secondary hypertension due to pheochromocytoma should be suspected.
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- 2022
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20. microRNA-17-5p downregulation inhibits autophagy and myocardial remodelling after myocardial infarction by targeting STAT3
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Bo Chen, Yingjun Yang, Jinbo Wu, Jianjiang Song, and Jia Lu
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myocardial infarction ,myocardial remodelling ,microrna-17-5p ,stat3 ,autophagy ,myocardial fibrosis ,cardiomyocyte apoptosis ,Internal medicine ,RC31-1245 - Abstract
MicroRNAs (miRs) are reported to regulate myocardial infarction (MI). This study was performed to investigate the function and mechanism of miR-17-5p in myocardial remodelling after MI. Initially, a mouse model of MI was established and MI mice were infected with lentivirus antago-miR-17-5p vector. High expression of miR-17-5p was found in myocardial tissues after MI. After inhibiting miR-17-5p expression, myocardial fibrosis, scarring, and cardiomyocyte apoptosis were improved, LC3-II/LC3-I ratio and Beclin-1 expression were decreased but p62 expression was increased. The dual-luciferase assay suggested that miR-17-5p targeted STAT3 and negatively regulated its expression. Then, after inhibiting STAT3 expression using STAT3 inhibitor S31-201, the fibrosis, scarring, and cardiomyocyte apoptosis were deteriorated, along with the rise of LC3-II/LC3-I and Beclin-1 expression, the reduction of p62 expression and the reversion of MI attenuation. In conclusion, inhibition of miR-17-5p can inhibit myocardial autophagy through targeting STAT3 and then inhibit myocardial remodelling, thereby protecting the myocardium after MI.
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- 2022
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21. Surgical management and outcome of left ventricular pseudoaneurysm: our 11-year experience
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Vaibhav Chugh, Rahul Bhushan, Narender Singh Jhajhria, Manpal Loona, Palash Aiyer, Vijay Grover, Vijay Gupta, and Anubhav Gupta
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left ventricular pseudoaneurysm ,myocardial infarction ,endocarditis. ,Surgery ,RD1-811 ,Internal medicine ,RC31-1245 - Published
- 2022
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22. Persistent ST Segment Elevation After Repeated Percutaneous Coronary Intervention: A Dressler Syndrome?
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Eka Ginanjar and Tanya Herdita
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case report ,percutaneous coronary intervention ,myocardial infarction ,dressler syndrome ,post myocardial infarction pericarditis ,Internal medicine ,RC31-1245 - Abstract
In the era of percutaneous coronary intervention (PCI), Dressler syndrome has become an extremely rare phenomenon. Originally known as post-myocardial infarction syndrome, it is characterized by fever, pleuritic chest pain, and pericardial or pleural effusion after myocardial infarction. It is one of the sub-entities of post-myocardial infarction pericarditis (PMIP). A 62-year-old man presented with persistent chest pain and diffuse ST segment elevation even after repeated PCIs. This condition was accompanied by fever and bilateral pleural effusion upon chest X-ray. The patient showed improvement in ST segment elevation and clinical condition after 2 weeks of steroid administration. The findings in this case suggest the possibility of PMIP. Although uncommon, physicians should be aware of the potentials of this condition in the differential diagnosis of chest pain after myocardial infarction and PCI so that immediate effective treatment can be given.
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- 2022
23. The Application of Coronary Contrast Emptying Time in Diagnosing Coronary Slow Flow Phenomenon: A Serial Case Report
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Yudhie Tanta, Ali Ghanie, Taufik Indrajaya, Erwin Sukandi, Imran Saleh, and Ziske Maritska
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coronary slow flow phenomenon ,microvascular disorder ,myocardial ischemia ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
The Coronary Slow Flow Phenomenon doesn’t achieve as much attention as its counterpart Coronary Arterial Disease because it is considered a rather benign entity. But now it is proven that coronary slow flow phenomenon can also manifest as an acute coronary syndrome, myocardial ischemia, malignant arrhythmia, and even sudden cardiac death. This entity is usually diagnosed from coronary angiography study when a delayed coronary contrast filling time is found without the presence of significant epicardial narrowing of the related arteries. But, in our center’s years of experience, we frequently found cases in which myocardial ischemia or infarction was suggested or proven clinically, on the other hand, angiography study showed no significant epicardial coronary artery narrowing neither delayed coronary contrast filling time. Furthermore, we observed that this group of patients exhibited a rather prolonged coronary contrast emptying time instead. In this serial case report, we presented some of our cases where microvascular disorders were suspected. We demonstrated that not all coronary contrast filling times in ischemic or infarction-related arteries were prolonged, on the other hand, prolongation of coronary contrast emptying time showed a more consistent result.
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- 2022
24. Glucagon-like Peptide-1 receptor Tie2+ cells are essential for the cardioprotective actions of liraglutide in mice with experimental myocardial infarction
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Brent A. McLean, Chi Kin Wong, M Golam Kabir, and Daniel J. Drucker
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Heart ,Myocardial infarction ,Diabetes ,Obesity ,Peptides ,G protein coupled receptors ,Internal medicine ,RC31-1245 - Abstract
Objectives: Glucagon-like peptide-1 receptor (GLP-1R) agonists reduce the rates of major cardiovascular events, including myocardial infarction in people with type 2 diabetes, and decrease infarct size while preserving ventricular function in preclinical studies. Nevertheless, the precise cellular sites of GLP-1R expression that mediate the cardioprotective actions of GLP-1 in the setting of ischemic cardiac injury are uncertain. Methods: Publicly available single cell RNA sequencing (scRNA-seq) datasets on mouse and human heart cells were analyzed for Glp1r/GLP1R expression. Fluorescent activated cell sorting was used to localize Glp1r expression in cell populations from the mouse heart. The importance of endothelial and hematopoietic cells for the cardioprotective response to liraglutide in the setting of acute myocardial infarction (MI) was determined by inactivating the Glp1r in Tie2+ cell populations. Cardiac gene expression profiles regulated by liraglutide were examined using RNA-seq to interrogate mouse atria and both infarcted and non-infarcted ventricular tissue after acute coronary artery ligation. Results: In mice, cardiac Glp1r mRNA transcripts were exclusively detected in endocardial cells by scRNA-seq. In contrast, analysis of human heart by scRNA-seq localized GLP1R mRNA transcripts to populations of atrial and ventricular cardiomyocytes. Moreover, very low levels of GIPR, GCGR and GLP2R mRNA transcripts were detected in the human heart. Cell sorting and RNA analyses detected cardiac Glp1r expression in endothelial cells (ECs) within the atria and ventricle in the ischemic and non-ischemic mouse heart. Transcriptional responses to liraglutide administration were not evident in wild type mouse ventricles following acute MI, however liraglutide differentially regulated genes important for inflammation, cardiac repair, cell proliferation, and angiogenesis in the left atrium, while reducing circulating levels of IL-6 and KC/GRO within hours of acute MI. Inactivation of the Glp1r within the Tie2+ cell expression domain encompassing ECs revealed normal cardiac structure and function, glucose homeostasis and body weight in Glp1rTie2−/− mice. Nevertheless, the cardioprotective actions of liraglutide to reduce infarct size, augment ejection fraction, and improve survival after experimental myocardial infarction (MI), were attenuated in Glp1rTie2−/− mice. Conclusions: These findings identify the importance of the murine Tie2+ endothelial cell GLP-1R as a target for the cardioprotective actions of GLP-1R agonists and support the importance of the atrial and ventricular endocardial GLP-1R as key sites of GLP-1 action in the ischemic mouse heart. Hitherto unexplored species-specific differences in cardiac GLP-1R expression challenge the exclusive use of mouse models for understanding the mechanisms of GLP-1 action in the normal and ischemic human heart.
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- 2022
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25. A known case of myocardial infarction and its outcome in pregnancy
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Veena M Vernekar, Mangal Gowri, Vedavathy Naik, Ashok Kumar, A Poojitha, S Raziya, and S Sreelatha
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echocardiogram ,myocardial infarction ,pregnancy ,primigravida ,vacuum-assisted vaginal delivery ,Internal medicine ,RC31-1245 - Abstract
Acute myocardial infarction (AMI) is rare in women of child- bearing age during pregnancy. Its prevalence is 1/10,000–30,000. A 32-year-old primigravida, with a history of acute MI 1 year ago, presented to us with regular antenatal checkups and was followed up to term. She was asymptomatic throughout her pregnancy. Electrocardiogram, two-dimensional echocardiogram, cardiology opinion, and preanesthetic evaluation were done. Under strict maternal and fetal monitoring, the mother went into spontaneous labor and delivered by vacuum-assisted vaginal delivery. Both the mother and the baby were stable and healthy. She was asymptomatic in her postpartum period and was discharged on postnatal day 8.
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- 2022
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26. Data on Heart Attack Discussed by Researchers at Department of Internal Medicine (Public interest in America on cardiac arrest following cardiovascular events of Bronny and Damar: A Google trend study).
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CARDIAC arrest ,MYOCARDIAL infarction ,INTERNAL medicine ,RESEARCH personnel ,PUBLIC interest - Abstract
The article explores how high-profile cardiac events involving celebrities Bronny James and Damar Hamlin have influenced public awareness and search trends related to cardiac arrest. Topics include the impact of these events on searches for cardiopulmonary resuscitation (CPR) and defibrillation, differences in public interest between the two incidents, and the overall increase in awareness following Hamlin's cardiac arrest.
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- 2024
27. Department of Internal Medicine Researcher Yields New Data on Heart Attack (Managing the Intricacies of Coronary Revascularization: A Close Look at the Complete Versus Culprit-Only Approach and its Implications in Elderly Patients).
- Subjects
MYOCARDIAL infarction ,OLDER patients ,INTERNAL medicine ,RESEARCH personnel ,CORONARY disease ,CARDIOMYOPATHIES - Abstract
A recent study conducted by the Department of Internal Medicine explores the management of coronary revascularization in elderly patients with acute myocardial infarction (MI). The study suggests that a more invasive complete revascularization approach may be favorable over incomplete or culprit-only revascularization in this population. The researchers discuss various procedures and guidelines for identifying culprit lesions, such as electrocardiogram procedures, coronary angiography, intravascular ultrasound, fractional flow reserve, and instantaneous fractional flow reserve. The study emphasizes the importance of considering frailty in the decision-making process for managing acute coronary syndrome in elderly patients. [Extracted from the article]
- Published
- 2024
28. Internal Medicine Department Researcher Highlights Recent Research in Heart Attack (Unraveling the Cardiac Matrix: From Diabetes to Heart Failure, Exploring Pathways and Potential Medications).
- Subjects
HEART failure ,MYOCARDIAL infarction ,DRUGS ,INTERNAL medicine ,RESEARCH personnel - Abstract
A recent study published in the journal Biomedicines explores the relationship between diabetes and heart failure following a heart attack. The study highlights the role of myocardial fibrosis, or abnormal extracellular matrix deposition, in cardiac remodeling and identifies SGLT2 inhibitors and GLP-1 receptor agonists as potential medications for managing type 2 diabetes and reducing fibrosis risk. The researchers analyze recent studies to identify effective medications in reducing cardiac fibrosis post-heart attack and improving patient outcomes. This research provides valuable insights into the potential benefits of anti-diabetic medications in individuals with diabetes at risk of heart failure. [Extracted from the article]
- Published
- 2024
29. Researchers at Department of Internal Medicine Release New Data on Acute Coronary Syndrome (Acute Coronary Syndrome Revascularization Strategies With Multivessel Coronary Artery Disease).
- Subjects
CORONARY artery disease ,ACUTE coronary syndrome ,INTERNAL medicine ,RESEARCH personnel ,HEART diseases - Abstract
A new report presents fresh data on acute coronary syndrome (ACS) and revascularization strategies. The study compared coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease (MV-CAD) and ACS. The research found that CABG was associated with lower mortality and fewer repeat ACS events at one year compared to PCI and medical management. These findings suggest that CABG may be the optimal revascularization strategy for patients with ACS and MV-CAD. [Extracted from the article]
- Published
- 2024
30. Timing of coronary artery bypass grafting after acute myocardial infarction: does it influence outcomes?
- Author
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Anton Thilak, Devika Thacker, Sufina Shales, Debasis Das, Sukanta Behera, Arup Ghosh, and Pradeep Narayan
- Subjects
coronary artery bypass grafting ,myocardial infarction ,timing ,Surgery ,RD1-811 ,Internal medicine ,RC31-1245 - Published
- 2021
- Full Text
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31. Spontaneous coronary artery dissection associated with incidental finding of left ventricular thrombus
- Author
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Melvin Santana, Nirmal Guragai, Biren Patel, Rahul Vasudev, Preet Randhawa, Meherwan Joshi, Habib Mirette, and Fayez Shamoon
- Subjects
spontaneous coronary artery dissection ,left ventricular thrombus ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Spontaneous Coronary Artery Dissection (SCAD) is one of the nonatherosclerotic causes of Acute Coronary Syndrome. It’s extremely rare for SCAD to present in an asymptomatic male, with incidental finding of Left Ventricular (LV) thrombus on echocardiogram. This report presents the case of a 36-year-old male with such an atypical presentation of Spontaneous Coronary Artery Dissection with Left Ventricular apical thrombus as a complication. The patient received successful medical management, with excellent clinical outcomes. This case highlights the importance of an early recognition and treatment strategy for both conditions using medical therapy.
- Published
- 2021
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32. Acute symptomatic seizures and ventricular fibrillation - a multimodality approach to a rare complication of myocardial infarction. Case report
- Author
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Miruna Florina Stefan and Stefania Lucia Magda
- Subjects
myocardial infarction ,ventricular fibrilation ,acute seizure ,Internal medicine ,RC31-1245 - Abstract
Background – 6-8% of patients with acute myocardial infarction still develop ventricular arrhythmias (VA), although their incidence has lowered due to prompt antiischemic treatment. VA might determine sometimes acute symptomatic seizures. Case report – A 44-year old male was admitted to our unit with acute inferior myocardial infarction. Emergency coronary angiography was performed and revealed acute occlusion of the right coronary artery. The procedure was complicated by coronary dissection, which was sealed, with good final results. After admission in the acute coronary unit, the patient developed ventricular fibrillation. He was successfully resuscitated, but developed ongoing tonic-clonic seizures, terminated after intravenous administration of several anticonvulsivant drugs. We investigated the patient for epilepsy and for other pathologies that could explain both the VA and the seizures. All investigations were within normal range. Conclusion – Differential diagnosis between hypoxic and epileptic seizures is difficult and important, because it further influences patient management. Cardiac arrhythmias are a rare precipitating factor for acute symptomatic seizures, due to hypotension-induced cerebral hypoxemia. Our case illustrates the value of a multimodal approach of rare complication of a myocardial infarction.
- Published
- 2021
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33. A rare cause of acute ST-elevation myocardial infarction: a case of coronary embolism secondary to calcified bicuspid aortic valve
- Author
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Anda Bularga, Andrew R Chapman, John Hung, Nicholas L. Mills, and Marc R. Dweck
- Subjects
myocardial infarction ,coronary angiography ,aortic valve stenosis ,Internal medicine ,RC31-1245 - Abstract
Coronary embolism is an uncommon cause of acute myocardial infarction, which can have a similar clinical presentation to a plaque rupture event with acute onset of ischaemic symptoms, ST segment elevation on electrocardiogram (ECG) and significant elevation in cardiac troponin, requiring immediate intervention. We report the case of a middle-aged female with a background history of previous non-ST elevation myocardial infarction, bicuspid aortic valve with severe stenosis and metastatic breast cancer. The patient underwent emergency coronary angiography following acute onset central chest pain and evidence of anterior ST segment elevation on ambulance 12-lead ECG. The procedure revealed complete occlusion of the mid left anterior descending coronary artery with immediate fl ow restoration following embolus aspiration and subsequent normal appearance of the left anterior descending coronary artery. Gross examination of the aspirated specimen resembled a calcified hard lump, which was further confirmed on microscopic examination revealing calcified fibrous tissue most likely an embolus from the calcified bicuspid aortic valve. The patient had evidence of near transmural myocardial infarction in the distribution of the left anterior descending coronary on cardiac magnetic resonance imaging (MRI). She made full recovery and was discharged on short-term dual antiplatelet therapy followed by lifelong aspirin and further assessment for aortic stenosis management.
- Published
- 2021
- Full Text
- View/download PDF
34. Genome-wide transcriptome study using deep RNA sequencing for myocardial infarction and coronary artery calcification
- Author
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Xiaoling Zhang, Jeroen G. J. van Rooij, Yoshiyuki Wakabayashi, Shih-Jen Hwang, Yanqin Yang, Mohsen Ghanbari, Daniel Bos, BIOS Consortium, Daniel Levy, Andrew D. Johnson, Joyce B. J. van Meurs, Maryam Kavousi, Jun Zhu, and Christopher J. O’Donnell
- Subjects
Gene expression signatures ,Protein-coding gene ,Long intergenic non-coding RNA ,Myocardial infarction ,Coronary artery calcification ,Whole blood ,Internal medicine ,RC31-1245 ,Genetics ,QH426-470 - Abstract
Abstract Background Coronary artery calcification (CAC) is a noninvasive measure of coronary atherosclerosis, the proximal pathophysiology underlying most cases of myocardial infarction (MI). We sought to identify expression signatures of early MI and subclinical atherosclerosis in the Framingham Heart Study (FHS). In this study, we conducted paired-end RNA sequencing on whole blood collected from 198 FHS participants (55 with a history of early MI, 72 with high CAC without prior MI, and 71 controls free of elevated CAC levels or history of MI). We applied DESeq2 to identify coding-genes and long intergenic noncoding RNAs (lincRNAs) differentially expressed in MI and high CAC, respectively, compared with the control. Results On average, 150 million paired-end reads were obtained for each sample. At the false discovery rate (FDR)
- Published
- 2021
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35. Reporte de un caso de pericarditis purulenta en un post operado de colecistectomía.
- Author
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Enrique Salgado-Fuentes, Carlos, Yoemi Lores-Galeano, Axel, and de las Mercedes Columbié-Castro, Glenda
- Subjects
MYOCARDIAL infarction ,PERICARDITIS ,INFECTION ,IDIOPATHIC diseases ,SURGICAL complications ,INTERNAL medicine - Abstract
Copyright of Universidad Médica Pinareña is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
36. The relationship between galectin-3 and SYNTAX Score I in patients with non-ST-segment elevation myocardial infarction
- Author
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Alaa Quisi, Gökhan Alıcı, Ömer Genç, Hazar Harbalıoğlu, and İbrahim Halil Kurt
- Subjects
atherosclerosis ,galectin-3 ,myocardial infarction ,syntax score. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: The expression of galectin-3 has been found to be increased in human atherosclerotic lesions, suggesting a role in atherogenesis. However, there is a lack of data regarding an association between galectin-3 and the extent, severity, and complexity of coronary artery disease (CAD). The aim of this study was to investigate the relationship between galectin-3 and SYNTAX Score I in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods: This study included a total of 95 consecutive patients who were diagnosed with NSTEMI and underwent coronary angiography. The baseline galectin-3 level of each patient was measured. The SYNTAX Score I of each patient was calculated using the online calculator (www.syntaxscore.com). The study population was divided into 2 groups: SYNTAX Score I ≤22 group (n=55) and SYNTAX Score I >22 group (n=40). Results: The galectin-3 level was significantly higher in the SYNTAX Score I >22 group than in the SYNTAX Score I ≤22 group (22.1+-8.3 ng/mL vs. 13.5+-7.7 ng/mL; p
- Published
- 2020
- Full Text
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37. Thrombotic events in COVID-19 patients: a case series and literature review
- Author
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Zahra Javidarabshahi, Shohre Khatami, Roxana Rezazade, Neda Saeedian, and Mahnaz Mozdourian
- Subjects
coronavirus disease 2019 ,thrombosis ,myocardial infarction ,pulmonary thromboembolism ,venous thrombosis ,Internal medicine ,RC31-1245 - Abstract
Background: Coronavirus disease 2019 (COVID-19) has rapidly emerged as a threatening pandemic. Clinical features of this pandemic involve a wide range of manifestations and are not completely known. Here, we present six cases of thrombotic events in patients with COVID-19. Case presentation: In this case series, we present six patients with confirmed COVID-19, according to real-time polymerase chain reaction, who were referred to our emergency department and were found to have thrombotic events. Pulmonary thromboembolism was diagnosed in three patients by computed tomography (CT) angiography. One patient was found to have deep vein thrombosis in Doppler ultrasonography. Another patient who presented with loss of consciousness, was finally diagnosed with cerebrovascular accident using brain CT. One of the patients had developed a myocardial infarction that was evident in the electrocardiography. Conclusion: It is ostensible that COVID-19 puts the patients at an increased risk for developing thrombotic conditions, possibly through formation of hyper-inflammatory and hyper-coagulative states. However, further prospective studies are recommended to confirm these findings.
- Published
- 2020
38. Periprocedural antiplatelet management in cardiac patients undergoing dental extraction: A case report and review of literature
- Author
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Ajay Agarwal, Osama Hallak, and Tanjeev Ahmad
- Subjects
Dental procedure ,Myocardial infarction ,Stent thrombosis ,Anti-platelet management ,Multidisciplinary care ,Internal medicine ,RC31-1245 ,Surgery ,RD1-811 - Abstract
Multidisciplinary care in healthcare is becoming the preferred approach to optimizing outcome. We present a case in which a patient developed a thrombotic occlusion of the mid left anterior descending coronary artery (very late stent thrombosis) leading to acute myocardial infarction while presenting for a dental extraction. Prior to the dental extraction his antiplatelet medication was held to minimize his risk of bleeding. This raises a question regarding the optimal use of antiplatelet medication during dental procedures. In complex cardiac patients we propose a multidisciplinary approach to antiplatelet management during the periprocedural period.
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- 2022
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- View/download PDF
39. The pregnancy-associated spontaneous coronary artery dissection in a young woman with a novel missense mutation in NOTCH1: a case report
- Author
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Bo Bai, Meng Zhang, Yihao Zhuang, Jirong Zhu, Wenjing Li, Wei Ma, and Haibo Chen
- Subjects
Spontaneous coronary artery dissection ,NOTCH 1 variant ,Myocardial infarction ,Primary percutaneous coronary intervention ,Pregnancy ,Internal medicine ,RC31-1245 ,Genetics ,QH426-470 - Abstract
Abstract Background Spontaneous coronary artery dissection (SCAD) is frequently reported as a disorder that primarily affects women without risk factors for cardiovascular disease. Although it has been recognized as one of the genetically mediated vascular disorders, the genetic pathogenesis of SCAD remains obscure to date. Case presentation In this report, we presented a rare case of pregnancy-associated SCAD in a young woman that occurred in multiple coronary arteries within a short period. The initial conservative management and then intravascular ultrasound-guided primary percutaneous coronary intervention (PCI) were adopted to achieve optimal results of revascularization in affected coronary arteries and avoid potential risks for PCI-associated complications. We further performed the whole-exome sequencing and Sanger sequencing and, for the first time, reported a novel heterozygous missense variant, c.4574 C > T (p.Arg1438Cys), in the NOTCH1 gene. This variant has never been documented in the medical literature and was predicted as being potentially damaging or disease-causing variant. Conclusions We described a rare case of recurrent SCAD in a young woman after baby delivery. The initial conservative management and PCI with multiple stent implantations were successfully implemented to achieve optimal results of revascularization in coronary arteries. We, for the first time, identified a novel missense variant in the NOTCH1 gene, which appears to be a potential predisposing factor for artery fragility.
- Published
- 2020
- Full Text
- View/download PDF
40. Relationship between histopathological features of aspirated thrombi and long-term left ventricular function in patients with ST-segment elevation myocardial infarction
- Author
-
Mehmet Onur Omaygenç, Cem Doğan, Adnan Somay, Oğuz Karaca, Ruken Bengi Bakal, Mehmet Kamil Teber, Suzan Hatipoğlu, Zübeyde Bayram, Cihangir Kaymaz, and Nihal Özdemir
- Subjects
inflammation mediators ,leukocyte count ,myocardial infarction ,thrombectomy ,ventricular remodeling. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: This study was an investigation of the severity of inflammation (SOI) in aspirated material and thrombus age to examine any association with pre-discharge and long-term left ventricular (LV) function after ST-elevation myocardial infarction (STEMI). Methods: The study group comprised 25 patients with STEMI from whom an occlusive thrombus was aspirated from the infarct-related artery with a 7-F catheter. The SOI in the aspirate was determined according to the mean leukocyte count in 5 high-power magnification fields and graded as mild in the presence of ≤100 leukocytes per field or significant if there were >100 leukocytes per field. The thrombi were categorized as fresh or lytic/organized (L/O) using predefined criteria. Echocardiographic assessment was performed prior to discharge and at 1 year. Adverse left ventricular remodeling (LVR) was defined as a 20% increase in LV end-diastolic volume in comparison with baseline values. Results: LVR was observed in 8 patients. The mean leukocyte count of the aspirate (127.5+-86.0 vs 227.2+-120.7; p=0.026) and frequency of significant inflammation (35% vs 75%; p=0.046) were significantly higher in the group with LVR. The serum high-sensitivity C-reactive protein (hsCRP) level was significantly correlated with the leukocyte count of the aspirate (r=0.532; p=0.006). An L/O thrombus was related to better pre-discharge and long-term LV volumes and ejection fraction values compared with a fresh thrombus. Conclusion: A significant increase in the leukocyte count in the aspirate and a fresh thrombus might predict long-term LV functional deterioration irrespective of the clinical and procedure-related characteristics. In addition, serum markers of inflammation, like hsCRP, might also reflect the intensity of the local inflammatory response at the site of occlusion.
- Published
- 2020
- Full Text
- View/download PDF
41. Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq
- Author
-
Amanj Abubakr Jalal Khaznadar and Rebin Wahid Salh
- Subjects
acute coronary syndrome ,myocardial infarction ,st-segment elevation myocardial infarction (stemi) ,non-st-segment elevation myocardial infarction (nstemi) ,iraq ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine the effects of age on the risk factors and clinical symptoms of acute coronary syndrome. Methods: A cross-section prospective study was conducted on 125 patients with acute coronary syndrome chosen by non-probability convenience sampling method in the coronary care unit in Sulaimani, the Kurdistan region of Iraq. Acute coronary syndrome types were diagnosed through clinical presentations, electrocardiography (ECG), and troponin test. Data was collected using a researcher-based checklist through face-to-face interviews. Results: The results indicated that males were the dominant group. The age group 45-65 had the highest prevalence rate of acute coronary syndrome. The most frequent risk factors for acute coronary syndrome were hypertension (54.4%), dyslipidemia (52%), smoking (42.4%), and diabetes mellitus (38.4%). Typical chest pain was found to be the most frequent clinical presentation (88%). There was a significant difference between the age groups in terms of the effect of age on typical and atypical symptoms; however, neither age nor typical/atypical symptoms had a significant effect on type of acute coronary syndrome. Similarly, family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia had no effect on type of acute coronary syndrome. Conclusion: Age is a predictive factor for acute coronary syndrome, but family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia cannot predict acute coronary syndrome.
- Published
- 2020
- Full Text
- View/download PDF
42. The relationship between a combination of vitamin D deficiency and hyperuricemia and the severity of coronary artery disease in myocardial infarction patients
- Author
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Mustafa Umut Somuncu, Nail Güven Serbest, Ferit Akgül, Mustafa Ozan Çakır, Tunahan Akgün, Fatih Pasa Tatar, Murat Can, and Abdulkadir Tekin
- Subjects
25-hydroxyvitamin d ,atherosclerosis ,gensini score ,myocardial infarction ,uric acid. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Vitamin D deficiency has been shown to be associated with coronary artery disease (CAD). In addition, there are studies suggesting that hyperuricemia is an independent risk factor for atherosclerosis, whereas the relationship between the combination of these 2 parameters and severity of CAD remains unclear. The aim of this study was to investigate the association between the combination of vitamin D deficiency and hyperuricemia and the extent of CAD. Methods: A total of 502 patients who had experienced myocardial infarction (MI) were included in this cross-sectional study. The 25-hydroxyvitamin D (25OHD) and serum uric acid (SUA) levels were measured in blood samples taken at the time of admission. A 2x2 factorial design was used to create groups according to the presence of hyperuricemia (>7 mg/dL) and vitamin D deficiency (
- Published
- 2020
- Full Text
- View/download PDF
43. Warm blood versus St. Thomas cardioplegia for myocardial protection in patients undergoing coronary artery bypass grafting
- Author
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Paolo Nardi, Calogera Pisano, Sabrina Ferrante, Fabio Bertoldo, Antonio Scafuri, Carlo Bassano, Antonio Pellegrino, Dionisio F. Colella, Dario Buioni, Emanuele Tedone, and Giovanni Ruvolo
- Subjects
cardioplegia ,coronary artery bypass ,myocardial infarction ,Surgery ,RD1-811 ,Internal medicine ,RC31-1245 - Published
- 2020
- Full Text
- View/download PDF
44. Rationale and design of the Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population (MINOCA-TR) study
- Author
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Uğur Önsel Türk, Mehdi Zoghi, Emin Alioğlu, and Oktay Ergene
- Subjects
demographics ,myocardial infarction ,non-obstructive coronaries ,prognosis. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a new term to define the syndrome of clinical evidence of MI occurring in the absence obstructive coronary artery disease. Given that there is believed to be a large number of MINOCA cases, effective diagnostic and therapeutic strategies are needed. Documentation of the demographic parameters and diagnostic methods used in existing cases is a first step. The purpose of this study is documentation of the prevalence, demographic details, and possible etiological causes, as well as inpatient and 1-year prognosis data of MINOCA patients in the Turkish population. Methods: The MINOCA-TR Study is a national, multi-center, prospective, observational study. A sample of 1028 conse-cutive MI patients who undergo diagnostic angiography will be enrolled. This is a cohort study that will include patients from 32 different centers. After an initial screening/enrollment visit, follow-up will be performed at the time of hospital discharge for the overall MI study population. Patients diagnosed as MINOCA will be followed up with 3 prospective office or telephone visits as part of the Prospective MINOCA Registry. Conclusion: Demographic information, clinical characteristics, management strategies, and inpatient prognostic indicators will be documented in the cross-sectional portion of the registry. Additional diagnostic data, therapeutic strategies, and prognostic relevance will be recorded in the 12 months of the prospective research. The results are expected to inform future diagnostic and therapeutic strategies and enhance understanding of the condition by highlighting the national burden of the disease from a medical and a public health perspective, as well as stimulate future research focusing on the MINOCA population.
- Published
- 2019
- Full Text
- View/download PDF
45. Characteristics of medical malpractice claims involving emergency medicine physicians.
- Author
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Myers, Laura C., Einbinder, Jonathan, Camargo, Carlos A., and Aaronson, Emily L.
- Subjects
MALPRACTICE ,PREVENTION of medical errors ,INTERNAL medicine ,PULMONARY embolism ,CONFIDENCE intervals ,MULTIPLE regression analysis ,RETROSPECTIVE studies ,MYOCARDIAL infarction ,HEALTH insurance reimbursement ,MEDICAL errors ,BENCHMARKING (Management) ,DESCRIPTIVE statistics ,CARDIAC arrest ,DAMAGES (Law) ,ODDS ratio ,PATIENT safety ,MEDICAL specialties & specialists - Abstract
Background: Identifying characteristics of malpractice claims involving emergency medicine (EM) physicians allows leaders to develop patient safety initiatives to prevent future harm events. Methods: A retrospective study was performed of paid/unpaid claims closed 2007 to 2016 from Comparative Benchmarking System. Claims were identified by physician specialty involved (EM, internal medicine, general surgery). Various characteristics were compared by physician specialty. Multivariable regression was performed to identify factors associated with claim payment, in which (1) physician specialty was included as a predictor and (2) only the subset involving EM physicians was analyzed. Results: Of 54,772 claims, 2760 involved EM physicians, 5886 involved internists, and 3207 involved surgeons. Death was the most common severity among EM claims (34%). Diagnosis‐related allegations accounted for 58%, higher than 42% and 11% of claims involving internists and surgeons, respectively (P < 0.0001). Thirty‐one percent was paid. The median indemnity paid on behalf of any defendant was $206,261 (interquartile range $55,065‐527,651). The most common final diagnoses were myocardial infarction (2%), pulmonary embolus (2%), and cardiac arrest (2%). Procedure‐related claims were associated with increased payment likelihood (odds ratio 1.21, 95% confidence interval 1.10‐1.34). Conclusion: Malpractice claims in EM are often diagnosis‐ or procedure related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
46. Blunt-chest-trauma-induced acute myocardial infarction
- Author
-
Senthil Kuma, Yogender Singh Bansal, Nikhil Mehta, Ritambhra Nada, Pulkit Girdhar, and Vikarn Vishwajeet
- Subjects
Thoracic Injuries ,Atherosclerotic Plaque ,Coronary Thrombosis ,Myocardial Infarction ,Morphological and Microscopic Findings ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Blunt chest trauma (BCT) is one of the rarest causes of acute myocardial infarction (AMI). This paper reports the case of a young married man who suffered from AMI due to BCT sustained in a fight with his wife. The histopathology examination revealed a rupture of atherosclerotic plaque with superimposed thrombus in the proximal left anterior descending artery. This report also reviews previously reported BCT-induced AMI cases in the literature.
- Published
- 2021
47. A case of dual left anterior descending artery with myocardial infarction
- Author
-
Abhaykumar Binodkumar Dheeraj, Sandeep Kumar Giri, and Pankaj Suresh Ghormade
- Subjects
Anomalous Left Coronary artery ,Myocardial Infarction ,Autopsy ,Medicine ,Internal medicine ,RC31-1245 - Abstract
The Left anterior descending artery (LAD) is a branch of the left main coronary artery which runs obliquely towards the apex of the heart in the anterior interventricular sulcus. Among all of the coronary arteries, the LAD artery has the most constant course. Amongst the anomalies of coronaries, the duplication or bifurcation of the LAD artery is infrequent. The classification of the bifurcation of the LAD has been extensively described in various reports with the widespread use of CT Angiography. We describe herein, an anomalous LAD detected on autopsy. This unusual case highlights the gross autopsy finding of Type-I anomalous dual LAD coronary artery in a young adult who died of Myocardial Infarction.
- Published
- 2021
48. Department of Internal Medicine Researcher Updates Current Study Findings on Reperfusion Injury (Galanin Coordinates Macrophage-Associated Fibro-Inflammatory Response and Mitochondrial Integrity in Myocardial Infarction Reperfusion Injury).
- Subjects
GALANIN ,INTERNAL medicine ,MYOCARDIAL reperfusion ,MYOCARDIAL infarction ,REPERFUSION injury ,RESEARCH personnel ,RETICULO-endothelial system ,MITOCHONDRIA - Abstract
A recent study conducted by researchers from the Department of Internal Medicine at Poltava State Medical University in Ukraine has found that the peptide galanin plays a crucial role in regulating cardiovascular health. The study focused on reperfusion injury, a fibro-inflammatory reaction that occurs after a heart attack and can lead to heart failure. The researchers discovered that galanin coordinates the fibro-inflammatory response and maintains mitochondrial integrity in post-infarction reperfusion injury. They also found that galanin treatment during the reperfusion phase reduced fibro-inflammatory responses and promoted the expression of specific markers associated with macrophages. These findings suggest that galanin could be a potential therapeutic target for post-infarct cardiovascular complications. [Extracted from the article]
- Published
- 2024
49. Research on Nephropathy Reported by a Researcher at Department of Internal Medicine (Contrast-induced Nephropathy: Incidence and Reversibility in Patients Undergoing High-risk Percutaneous Coronary Intervention).
- Subjects
CONTRAST induced nephropathy ,PERCUTANEOUS coronary intervention ,INTERNAL medicine ,KIDNEY diseases ,RESEARCH personnel ,MYOCARDIAL infarction ,CARDIAC catheterization - Abstract
A recent study conducted in New Delhi, India, aimed to determine the incidence and reversibility of contrast-induced nephropathy (CIN) in patients undergoing high-risk percutaneous coronary intervention (PCI). The study included 50 consecutive cases and found that the incidence of CIN in high-risk PCI cases was 18%. Age above 70 years, hypertension, and diabetes were identified as significant predictors of CIN development. However, all cases of CIN had a self-limiting course and did not require renal replacement therapy. The study concluded that CIN affects approximately one out of every five to six high-risk PCI cases, but it is reversible. Patients with preexisting comorbidities such as diabetes and hypertension have a higher risk of developing CIN. [Extracted from the article]
- Published
- 2024
50. International Council for the Exploration of the Sea (ICES) Researcher Updates Knowledge of Cardiology (Ambulatory Cardiology or General Internal Medicine Assessment Prior to Scheduled Major Vascular Surgery is Associated with Improved Outcomes).
- Subjects
INTERNAL medicine ,VASCULAR surgery ,RESEARCH personnel ,CARDIOLOGY ,MYOCARDIAL infarction ,CARDIOVASCULAR disease related mortality - Abstract
A recent study published in the Annals of Surgery examined the association between ambulatory cardiology or general internal medicine (GIM) assessment prior to major vascular surgery and patient outcomes. The study, conducted in Ontario, Canada, included a population-based retrospective cohort of adults who underwent scheduled major vascular surgery. The results showed that patients who had an ambulatory cardiology or GIM assessment prior to surgery had better outcomes, including lower 30-day mortality rates and lower rates of secondary outcomes such as myocardial infarction or stroke. The researchers concluded that further research is needed to better understand the potential mechanisms of these benefits. [Extracted from the article]
- Published
- 2024
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